ASSOCIATION OF AUTONOMIC NERVOUS DYSFUNCTION AND ESOPHAGEAL DYSMOTILITY IN SYSTEMIC-SCLEROSIS

Objective. The primary event in the pathogenesis of gastrointestinal i nvolvement in systemic sclerosis (SSc) has been hypothesized to be an early neural lesion. We investigated the association of autonomic nerv ous dysfunction and esophageal involvement in SSc.; Methods. Thirty-si x consecutive patients with SSc were investigated by esophageal manome try and autonomic nervous function tests for cardiovascular and pupill ary autonomic dysfunction. Results. In 27 of 36 patients, esophageal m anometry showed esophageal dysfunction. Twelve patients had either pup illary (n = 6) or cardiovascular (n = 5) dysfunction or both (n = 1). All patients with autonomic dysfunction had esophageal dysfunction. Pa tients with autonomic dysfunction had significantly reduced mean dista l esophageal contraction amplitudes compared to patients without auton omic nervous dysfunction (p<0.05). The association of autonomic dysfun ction and esophageal dysfunction was significant (p = 0.02). Conclusio n, Our results support the concept of a role for neurogenic defects in the development of esophageal dysfunction in SSc.